Dear Colleagues,
We had published the first quality improvement exercise called Project NIK (aimed at standardising the intubation process in neonates) 8 weeks agao. This includes how to standardise premedications and human factors in elective intubation.
We have now developed the 2nd quality improvement exercise called Difficult Neonatal Airway management which looks at standardisation of teams, approach when you encounter
difficulties with face mask ventilation, intubation or the placement of the airway adjuncts in neonates.
There are 9 modules with a number of videos to access for training purposes.
Dr Alok Sharma
Consultant Neonates
Southampton

The European Neonatal Ethics Conference is one of the premier events discussing issues involving ethical care around a variety of aspects in neonatal care. It is held every 3 years and is being held in Southampton United Kingdom this year. Besides addressing a number of different topics including issues of neonatal palliative care, organ donation and extremes of viability it is opportunity to share ethical practice across Europe.
Venue -St Mary's Stadium Southampton UK Dates 14th & 15th November 2019
Initial Flyer
Call for Abstracts-We are calling for abstracts for oral presentations, poster presentations, debates and round table discussions. More details are available here
Website-http://www.wonepedu.com/NeoEthics-Conference.html
Video-

Dear Martin,
I am curious what saturations to you target in the delivery room and first 2 hours Martin
Do you start with an FIO2 of 100
My assumption if you use AC is you want the baby to trigger. Do yo use any sedation and have you stopped using routine paralysis?
Alok

MPROvE Neonatal Simulation Instructor Course
Dear Colleagues,
We have 8 places for the next Neonatal Simulation Instructor Course to be run in Antrim near Belfast in 2019-Course Details
Course Background
This course is run to accredit and train neonatal staff in delivering simulation, debriefing moulage and high fidelity simulator use.
The course addresses the following over 2 days-
•Educational principles in simulation, Adult learning theory,
•Modelling delivery of your simulation programme
•Scenario design, Packaging of Scenarios, Manikin Modification and Moulage
•Debriefing principles, Debriefing styles, Difficult Debriefing
•Running high fidelity simulation and equipment training
•Issues of confidentiality and ethics
•Simulating death
Course Dates 31st January and 1st February
Registration
Moulage is taught and all the resources provided
For instructors wanting to take things further there is accreditation programme. The course comes with a full package of neonatal scenarios, toolkits for quality improvement and videos for use. More details are on
https://www.mproveacademy.com/

Dear Colleagues,
I hope this email finds you in the best of health and good spirits. For those of you who run simulation related activity in neonatology we have a website where resources can be accessed. Simulation scenarios are added every month and can be accessed here https://www.mproveacademy.com/mprove-academy/scenario-bank
Moulage to improve your neonatal scenarios can be accessed here https://www.mproveacademy.com/mprove-academy/scenario-bank
If you just want to access videos to teach and train your trainees and colleagues they can be accessed through the scenarios or on this website below
https://www.youtube.com/channel/UC22LMIG5Bwqhreic_DFHATw?view_as=subscriber
There are playlists on Neonatal Procedural Skills, QI initiatives, and Human Factors training in neonatology.
Hope this helps. If anyone has any ideas about using technology enhanced learning in neonatology that we can share please dont hesitate to be in touch.
Alok Sharma
Consultant Neonatologist
Southampton UK

Thanks Zuzanna we already have. We have implemented standard practice of placing the resuscitaire temperature probe in the baby's axilla after birth. The resuscitaire is switched to servocontrol at 37 C. At 5 minutes if the baby is still hypothermic a gel matress is added. The key is there is a dedicated person monitoring the temperature throughout the resuscitation. We have had a significant improvement in our thermal outcomes over the past year. The key thing is whether this is sustained.

Gayle that's fantastic. We use servocontrol as well just like you and cannot monitor in transport. We do however do a digital temperature just before we leave the delivery area to make sure it correlates and on arrival in the NICU because distances are large. It just means that if a baby is hypothermic at any point that becomes a point at which to intervene. Using this we have had only one preterm baby with a temperature under 36.5C last year. This was without increasing rates of hyperthermia on our NICU. We used a standardised protocol (www.mproveacademy.com go to scenarios and look at https://www.mproveacademy.com/mprove-academy/scenario-bank)
You are looking for Thermal Care.
Alok

Dear Colleagues,
I am a consultant neonatologist from Southampton United Kingdom.
We have run a quality improvement initiative with regards to thermal outcomes in in preterm neonates admitted to the NICU after birth called Project SHIP. This involves standardising management of preterm birth from before delivery to admission to the NICU. As part of this we are doing a short survey on practice in this regard world wide.
I would be grateful if you could answer a few questions in this regard.
Dr Alok Sharma
draloksharma74@gmail.com
Twitter: @draloksharma74

Dear Colleagues
I was wondering whether anyone can provide me with an evidence based article justifying this for neonates in incubators and providing me the rationale. For a baby in an incubator how would a cap and mask reduce infection
Alok

I have a a 30 day of neonate with CDH. never been extubated. Got him down to 50% and in 0.5-1ppm of Nitric Oxide. Have tried weaning him slowly of the NO on multiple occasions. Always go into 90% TO 100% Fio2. Already on maximum doses of Sildenafil. Not oedematous on PCAC 20/5 with good CO2 clearance. I cannot get the final bit of NO off.
Any strategies from the forum would be greatly appreciated.
PS Operated not paralysed synchronising well good drive

How are you managing their GUTS after birth. We deliver between 12-15 an year have not had a death due to the gut being an issue ever. The one problem is leaving them to go post term. The defect starts closing causing the bowel to become ischemic. Most of ours will get induced around 38 weeks. We use silos in 90% of cases
Alok